Developing a Culture of Evidence-Based Practice

The American Diabetes Association helps individuals diagnosed with type 1, type 2 or gestational diabetes find programs, current research and resources within their community (2022 A). Their mission is to improve the quality of life of those diagnosed with diabetes (American Diabetes Association, 2022 A). Upon reviewing their website and associated links, it is obvious that their research is based off evidence-based practice.

Evidence based practice allows healthcare providers to make informed decisions while caring for their patients (Walden University, LLC. (Producer), 2018). The information presented on their website is based off current research with a history of positive outcomes, such as treating type 2 diabetes with an appropriate diet, exercise and medications, if needed (American Diabetes Association, 2022 B). Recommendations from their website are largely based on research and evidence-based practice from medical providers (American Diabetes Association, 2022 A). The website’s main page directs users to many links regarding important information for prevention, treatment, resources, services and the most current research regarding diabetes (American Diabetes Association, 2022 A). This is where I found the most proof of evidence-based practice within the organization.

Implementing evidence-based practice in healthcare supports a standard for clinical practice and improves clinical outcomes for patients (Melnyk et al., 2010). My perception of the American Diabetes Association is that they are indeed founded on evidence-based practice. Their website provides a wealth of valuable information to anyone who may have been diagnosed with diabetes, are caring for someone with diabetes or are at risk for diabetes.

References

American Diabetes Association. (2022 A). American Diabetes Association. Retrieved from https://www.diabetes.org/

American Diabetes Association. (2022 B). Type 2 Diabetes. Retrieved from https://www.diabetes.org/diabetes/type-2

Melnyk, B.M., Fineout-Overhold, E., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51-53.

Walden University, LLC. (Producer). (2018). Introduction to Evidence-Based Practice and Research [Video file]. Baltimore, MD: Author.

Posted in the wrong week of the discussion.

I think you posted a wrong discussion board.

Evidenced-Based Practice has been described as a problem-solving approach to the delivery of health care. When it’s delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved. (Melnyk, et al, 2011).

All facets of the EBP must be included in order for it to be successful. The 3 components that must be present include best practice, clinical expertise, and patient preference and values (Walden, 2018).

Dissemination of EBP is the last step in which outcomes are shared. This could be done through grand rounds, poster presentations, or a published manuscript. (Milner, K.,2021)

Two mechanisms of dissemination of Evidenced-Based Practice (EBP) Material that I would utilize would be ground round presentation and Poster Presentation. The presentation will include a description of the project, objective, data analysis, outcomes, and lessons learned. (Humbles, et al 2019) I would use the ground rounds because it provides a forum to share our best practice and other topics of interest. The event will be planned in advance so that Staff and administration will attend. I would be able to present the information to all involved at the same time and they will hear the same information at the same time.  Also, this method is visual and there will be time for questions and answers.

My second preference will be the poster presentation. This is also visual. I believe it would be remembered. Lastly, copies of the posters can be replicated and posted in strategic locations for everyone to see. Both methods are interactive.

A barrier I would encounter with grand rounds is that it requires an event center and one has to be in-person to get the full benefit. To overcome the barrier you can have a zoom grand round. However, the experience will not be the same.  A second barrier will be the cost of presenting and preparing the material. I would also need to have others involved to participate in the presentation or at least approve it which might involve a lot of time.

References:

Gallagher-Ford, L. , Fineout-Overholt, E. , Melnyk, B. M. & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change. AJN, American Journal of Nursing, 111 (3), 54-60. doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e.

Humbles, Patricia,PhD., R.N., & Jones, Sylvia, MSN/Ed,R.N., P.H.N. (2019). Faculty and students find a niche in scholarship: Teaching strategies to disseminate scholarly evidence-based practice projects. ABNF Journal, 30(4), 109-112. Retrieved from https://www.proquest.com/scholarly-journals/faculty-students-find-niche-scholarship-teaching/docview/2336263321/se-2?accountid=14872

Milner, K. (2021). Evidence-Based Practice and Dissemination Strategies. Role Development for the Nurse Practitioner, 33.

Walden University, LLC. (Producer). (2018). Evidence-based Decision Making [Video file]. Baltimore, MD: Author.

I enjoyed reading your discussion board. Yes, Evidence-based Practice has been in place and has been used to solve many medical problems and new existing problems. According to the article Why evidence-based Practice in nursing is so important,”nurses learn about evidence-based Practice (EBP), which aids them in pinpointing care strategies that can help their patients. In recent decades, EBP has become a key component of exceptional patient care (2022).”

I agree with you on choosing the ground round method of sharing information in healthcare. The ground round method improves patient out. According to the article Nursing grand rounds, “Nursing Grand Rounds provides a forum for nurses to share clinical expertise and experiences, nursing best practices and other topics of interest that help improve patient outcomes and enhance the patient experience .” Great post!

Reference

Nursing grand rounds. Stanford Health Care (SHC) – Stanford Medical Center. (n.d.). Retrieved April 23, 2022, from https://stanfordhealthcare.org/health-care-professionals/nursing/professional-excellence/nursing-excellence/nursing-grand-rounds

Why is evidence-based practice in nursing so important? Eastern Illinois University. (2022, April 21). Retrieved April 23, 2022, from https://learnonline.eiu.edu/programs/rn-to-bsn/evidence-based-practice-important/

Grand rounds are a great way to focus on one point that iis specific to clinical practice. I did a grand round related to identification of substance abuse users and drug seeking behaaviorss. The audience was nurse practitioners and physicians.  After the initiaal content was offered, the diaaligue between us aall supported application to specific clinicaal experiences. As you note, it is key to match the presentation to your audience!

Dr. B.

Hello Professor,

Thanks for your enlightenment and all you did for my class. I will always remember you for your dedication ad support

Shirley Harleston.

Hello Shirley,

thank you for your informative post about the methods you would use to disseminate evidence. I agree, posterboard displays are visually appealing and easily remembered. According to Melnyk & Fineout-Overholt (2018), poster displays allows for more interaction between colleagues, enabling evidence to reach more people. However, I do believe creating a poster within an organization’s guidelines can be a barrier and limiting, visually.

I do like the thought of a grand round, although more formal than a poster. According to the Agency for Healthcare Research Quality (AHRQ, n.d.) grand rounds present a translation strategy, where education outreach and academic detailing are consistently effective interventions. An added benefit to grand rounds is the question-and-answer period that follows the presentation engaging participation (Melnyk & Fineout-Overholt, 2018).

Agency for Healthcare Research and Quality. (n.d.) Communication and dissemination

strategies to facilitate the use of health-related evidence. Retrieved on April 24, 2022,

from https://effectivehealthcare.ahrq.gov/products/medical-evidence-

communication/research-protocol

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare:

A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Thanks for your input. Posters are effective for educational purposes as well. In my organization posters are used during training. The posters will contain the information followed by questions that have to be answered by staff to make sure the information has been understood. These posters will be in a particular location for a limited period of time, and all staff are mandated to read and complete all the questions before the deadline.

Hello Shirley,

As we know Evidence-Based Practice is The knowledge, judgment, and critical reasoning acquired through your training and professional experiences. It’s not only in nursing but in almost every professional field known, it separates the people who are capable and the people who are not. (Evidence-Based Practice (EBP), 2022) The best thing to do with your suggestion is to plan, the problems you mention will only be really impactful if things are not planned well. We know planning  the fundamental management function, which involves deciding beforehand, what is to be done, when is it to be done, how it is to be done and who is going to do it (What Is Planning? Definition, Characteristics, Steps and Importance – Business Jargons, 2016), this saves a lot of wasted effort and also time to be able to reach the goal as fast as possible.

Evidence-Based Practice (EBP). (2022). Asha.org. https://www.asha.org/research/ebp/#:~:text=Evidence%2Dbased%20practice%20(EBP)%20is%20the%20integration%20of,your%20training%20and%20professional%20experiences 

What is Planning? definition, characteristics, steps and importance – Business Jargons. (2016, December 3). Business Jargons. https://businessjargons.com/planning.html

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Thanks

Hey shirley,

I enjoyed reading your post! Evidence based practice(EBP) can help rejuvenate the healthcare organizations in the nation. Having strategies for evidence based practice give nurses the knowledge and skills they need to implement EBP consistently (Gallagher-ford et.al, 2011). The poster presentation is a great strategy to implement because it will always be on display for people to read on their free time. Evidence based practice is being implemented all around. For example, at The Ohio State University Wexner Medical Center, the primary responsibility of the clinical nurse specialists throughout the healthcare system is to serve as EBP mentors for point of care staff in improving patient outcomes (melnyk et al., 2017).

References

Gallagher-Ford, L. , Fineout-Overholt, E. , Melnyk, B. M. & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change. AJN, American Journal of Nursing, 111 (3), 54-60.

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC© Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews on Evidence-Based Nursing, 14(1), 5–9.

I appreciate your input. Thanks.

Type of dissemination strategy

EBP utilizes recent information from various medical sources such as journals or research to improve patients’ treatment outcomes, boost their quality of life, and improve their recovery period. Dissemination is the specified distribution of facts and intervention materials to a particular spectator, health care personnel, or the community. The primary goal of dissemination is to encourage the spread of information that can improve an outcome (Malin et al.,2011). Strategies employed for spreading EBP include journals, podiums, and poster presentations.

Medical journal

This document commutes medical information written by peers to fellow healthcare professionals to broaden their understanding of specific topics. Journals typically have extensive research done; hence colleagues can appreciate the data and findings that purport that topic. Examples of EPS spread through journals include infection control. In addition, it entails how the hospital environment should be clean, wearing personal protective clothing, and practicing handwashing. This information benefits hospital which is the unit level for introducing EPS. Medical journals reach regional levels when spread via coworkers or platforms shared, such as the American Nurses Association (Li et al.,2019).

At the state and national levels, journals have been published on sites such as PubMed for nurses to provide unconfined access for all professionals globally to improve the patient’s treatment plan. An excellent medical journal involves using expertise within the field of research, extensive research, translation into guidelines, and implementation of the strategies in the Evidence-Based Practice journal. Since the introduction of EBP, the healthcare system has been renovated regarding the conveyance of health. In turn, it reduced terrestrial differences in care and cost. The releasing of journals is communicated via mass media, opinion leaders, and change champions (Stevens, 2013)

References

Bartelt, T. C., Ziebert, C., Sawin, K. J., Malin, S., Nugent, M., & Simpson, P. (2011). Evidence-based practice: perceptions, skills, and activities of pediatric health care professionals. Journal of pediatric nursing, 26(2), 114–121.

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine, 98(39), e17209.

Stevens K. R. (2013). The impact of evidence-based practice in nursing and the following big ideas. Online journal of issues in nursing, 18(2), 4.

You validate the use of journals to disseminate information.  What methods would you not use and what iss your rationale?

Dr. B.

Hi Hope,

Evidence based practice helps better serve our patients and community. As healthcare providers, I believe we should always question our practice and make improvements as current research warrants. Evidence based practice is correlated with improved quality of care and patient outcomes (Chien, 2019). Medical journals are a great resource for nursing research. The knowledge gained from evidence-based practice resources can help guide our practice, while making informed decisions regarding a patient’s care plan (Li & et al., 2019).

References:

Chien L. Y. (2019). Evidence-Based Practice and Nursing Research. The journal of nursing

research : JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes,

implementation, facilitators, and barriers among community nurses-systematic

review. Medicine, 98(39), e17209. https://doi.org/10.1097/MD.0000000000017209

Good evening Hope,

Thank you for your discussion response; it was very informative. I do agree that medical journals have enhanced the knowledge of healthcare professionals to provide better healthcare services. The medical advancements through research have improved the quality of life of the aging population because better treatment options became available through evidence-based practices (EBP). According to Li et. al., (2019), EBP is using scientific and evidence-based research to foster clinical decisions to effectively care for patients and improve safety. Another way that journals can be disseminated is through journal clubs either using the internet or in person. In-person or onsite journal clubs are formed to allow clinicians a chance to obtain and disseminate their knowledge while in the work setting (Melnyk & Fineholt-Overholt, 2019). This strategy can be beneficial if colleagues participate; experts are very knowledgeable in their field and topics are very relevant and interesting to the health care professionals.

Melnyk, B., & Fineholt-Overholt, E. (2019). Evidenced based practice in nursing and healthcare (4th ed.). Wolters Kluwer.

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses—systematic review. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

Hello Hope,

EBP refers to using the best available evidence for decision-making and providing efficient and effective care for patients on a scientific basis. (Li et al., 2019) It is a very notable and well-acclaimed practice for nurses to follow for the best results and outcomes for both nurses and patients, knowing and putting EBP into practice at a professional level can almost guarantee the best possible results. A medical journal is a very good choice is learning more data as stated that the first 2 scientific journals in the world: the “Philosophical Transactions of the Royal Society.” The other was the “Journal des Scavants” (Scholars) which appeared in France the same year. From these 2 journals are descended the many thousands of scientific periodicals today, including all those devoted to the biomedical sciences and medicine, whether they be in print or newer media such as on CD or the Internet.  (Medical Definition of Medical Journals, 2021)

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

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Medical Definition of Medical journals. (2021, March 29). MedicineNet; MedicineNet. https://www.medicinenet.com/medical_journals/definition.htm

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Hello Hope,

You mentioned the use of medical journals as a good way to disseminate evidence-based information.  The use of journals is an excellent way to place the healthcare institution’s idea high in the public that may provide some positive business opportunities.  However, with using journals there may be limitations in over relying on scientific methods to solve problems rather than other traditional problem- solving methods (Bordoni, 2019). There may also be concerns that only a small number of individuals have deep level of understanding of issues, so the facility rarely achieves High Reliability in results.  According to Melnyk, High Reliability Organizations creates a culture of processes that improves outcomes and reduces system failures.

References

Bordoni B. (2019). The Benefits and Limitations of Evidence-based Practice in Osteopathy. Cureus, 11(11), e6093. https://doi.org/10.7759/cureus.6093

Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation the ARCC Model for Systemwide Sustainability of Evidence-Based

Practice. Nursing Administration Quarterly, 36 (2), 127-135. doi: 10.1097/NAQ.0b013e318249fb6a

In the medical profession, medical journals contribute and add to the knowledge needed for best practice. In my personal opinion, I have learned a lot from reading medical journals. Some nurses that I know like to share articles within medical journals through emails of social media. The key is to get informed about the best ways to take care of our patients. The sad truth is that not all medical professionals are willing to practice what they are taught through evidence-based practice. The struggle we face as healthcare providers is the lack of knowledge and skills in evidence-based practice (Melnyk & Fineout-Overholt, 2019, p. 331). Unit nurse managers are faced with the challenge of leading their team through change from traditional practice to best practice and unfortunately the change is not always welcomed.

Reference

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.